The kidney performs essential physiological roles ranging from metabolic waste excretion to homeostatic functions such as osmoregulation. Kidney diseases are currently a global public health problem, with an incidence that has reached epidemic proportions and continues to climb in the U.S. and worldwide. The increase in kidney diseases correlates with the rise in the aged population and the increasing prevalence of conditions that cause renal complications, such as cardiovascular disease, hypertension, and diabetes. Kidney diseases also result from congenital defects and from acquired conditions such as acute kidney injury (AKI) or chronic kidney disease (CKD). AKI involves a rapid loss of kidney function from sudden renal cell damage, which can be triggered by ischemia, toxins, or sepsis. CKD is typified by the progressive loss of kidney function over time due to fibrosis and the erosion of healthy tissue. Kidney disease leads to organ failure, known as end-stage renal disease (ESRD). Some current therapies for ESRD are renal replacement with dialysis or transplantation. These clinical managements for renal failure have a high mortality rate, necessitate intensive, long-term care, and place a considerable burden on patients and their families, and a tremendous socioeconomic strain on healthcare systems.
Glomerular diseases account for 90% of end stage renal disease at a cost of $20 billion per year in the U.S. According to the United States Renal Data System, there are approximately 26 million adults in the U.S. who have CKD, and there are 100,000 new patients who start on dialysis each year. $39 billion in direct U.S. costs each year are attributable to patients with end stage renal disease, which is associated with an approximate 20% mortality rate per year and an average life expectancy of a patient initiating dialysis of approximately four years.
Stem cell therapy, while offering exciting avenues for treatment of kidney disease, is problematic in the collection of stem cells. Bone marrow cells are a common source of stem cells, but accessing such cells is a very invasive procedure with significant risks.